Has church ordered previously? Select Yes No   Order Date      Date Needed

Person Ordering       Position

Church Phone   ext.    Church Fax

Day Phone  ext. Is that # Select work home ?

E-mail address 

We need Church information before processing any order.  We prefer shipping to the Church.

Church Name  

Church Delivery Address (include street, city, state & zip)

Church Billing Address if different (include street, city, state & zip)

Ship to if different than Church: Select work home (include street, city, state & zip)

Method of Payment (Check one):

         Select Church Purchase Order Bill to Church Sent Check Church Credit Card Personal Credit Card

        Please indicate in the box below:

    *If ordering by Church Purchase Order indicate Church Purchase Order Number;

    *If ordering by Check indicate Check Number;

    *If ordering by Church Credit Card indicate Type of Card, Card Number & Expiration Date;

    *If ordering by Personal Credit Card indicate Name on Card, Type of Card, Card Number, Expiration Date, Daytime Phone of Cardholder, Street Address & Zip only.

Tax Exempt #

The Regular Sets are sold as one clip and one ring. No Minimum required.  You can mix the sets anyway you need.  Please indicate if changing from the Regular Set. Ring Side only $0.75/ Clip Side only $1.00.  Please realize that if you order Clip Side only or Ring Side only you are ordering half of a set.  Double your quantity if you would like a Ring Side Set or a Clip Side Set.   * Custom orders with your logo, minimum 250 sets, allow 8 weeks for delivery.  Parents Add-On-Coil Bracelets @ $0.60.  (Choose from white, clear, black, red, blue, lime green, yellow (greenish) or assorted).  In addition, we also have clear vinyl pouches that attach to the clip side which can hold a name tag for an additional $0.40.

1) Design and Quantity :

2)    Type:  Make Your Selection Regular Set Ring Side ONLY Clip Side ONLY

3)     Price Each

Price Each:      Total:

4)    Additional Options:

  5)    Comments or Special Instructions:

6)  Total Amount for Kiddie Keepers and Optional Items: 

7)    If you are ordering additional items please use the spaces below:

8)   Sales Tax * On GA customers only* County:   Tax%: Total Tax:

9)    Shipping Charges as indicated below:  

Stock SHIPPING SCHEDULE: General Shipping for items shipped from our in-stock products.

$0-10 =$5.00   $11-25 =$5.50   $26-50 =$6.00   $51-100 =$6.50   $101-150 =$7.00   $151-200 =$7.50

Add $1 for every $50 over $200 (Some items may be more / EX. mugs, squeeze bottles, etc.)

Add $2 for Residential Delivery (includes offices in homes).

Add approximately $10 for UPS 3 day select / $15 for UPS blue 2 day service

Please Note: If you are ordering two or more stock items EX: Kiddie Keepers and Stock Diaper Bag Tags add one shipping charge to the total order.  Stock shipments are totaled and shipped together from our office.

10)   Total Purchase Amount:

We consider it a blessing to be a part of your ministry!!!

Jamie Cardell, Pam Reeves, Christy Carlisle, Deanna Burkhardt and Joy Carlisle